Descriptive epidemiology of gastroschisis in China from 2007 to 2020: a nationwide surveillance-based study

Abstract

Background: Gastroschisis is a common abdominal wall defect that increases infant mortality risk and health care costs. However, recent epidemiological data on gastroschisis in China is limited.

Methods: Using 2007-2020 data from the Chinese Birth Defects Monitoring Network (CBDMN), we analyzed gastroschisis prevalence rates stratified by birth year, maternal age group, residence area, geographical region, and infant sex. We also examined the temporal variations in prevalence, pregnancy outcomes of affected infants, prenatal diagnoses, and co-occurring anomalies.

Results: From 2007 to 2020, a total of 6,813 cases of gastroschisis were identified among 25,909,000 births, comprising 4,675 isolated and 2,138 non-isolated cases. Prevalence rates per 10,000 live and still births were 2.63, 1.80, and 0.83 for the overall, isolated, and non-isolated gastroschisis, respectively, all showing a decreasing trend over the study period. The prevalence of overall gastroschisis varied significantly by maternal age (< 20 years, 9.88/10,000; 20-24 years, 4.17/10,000; 25-29 year, 2.08/10,000; 30-34 years, 1.88/10,000;≥35 years, 2.24/10,000), maternal residence (urban, 2.45/10,000; rural, 2.85/10,000), geographic region (central, 2.54/10,000; east, 2.57/10,000; west, 2.80/10,000), and infant sex (male, 2.13/10,000; female, 1.79/10,000). Non-isolated gastroschisis cases had a higher early neonatal mortality rate than isolated cases (41.91% vs. 28.10%) and frequently co-occurred with musculoskeletal anomalies.

Conclusions: This study highlights a declining trend in gastroschisis prevalence in Chinese population, a contrast to previous studies, and underscores the need for improved perinatal management due to adverse pregnancy outcomes associated with this condition.

Keywords: Chinese; Epidemiology; Gastroschisis; Prevalence rate.

Fig. 1

Time trends in the prevalence of gastroshisis in China, 2007–2020. (a) Stratified by case type (overall, χ² = 378.89, p < 0.001; isolated, χ² = 425.44, p < 0.001; non-isolated, χ² = 18.03, p < 0.001), (b) stratified by maternal residence (urban, χ² = 125.17, p < 0.001; rural, χ² = 256.06, p < 0.001), (c) stratified by infant sex (male, χ² = 242.30, p < 0.001; female, χ² = 464.64, p < 0.001), and (d) stratified by maternal age (< 20, χ² = 9.63, p = 0.002; 20–24, χ² = 158.25, p < 0.001; 25–29, χ² = 71.35, p < 0.001; 30–34, χ² = 17.88, p < 0.001; ≥35, χ² = 24.44, p < 0.001)